Being conservative is the safest approach. I would encourage you to try all of those first. I did that for a good 30 years and put off the surgery. Some seasons were worse but I always felt I’d know when those were exhausted. Massage, PT, chiropractic, acupuncture, dry needling. I didn’t want pain management with drugs. I paid for all those things out of pocket. Pain management my insurance would pay for - but they dictated the treatment. After one injection on the path to ablation the doctor wisely, and thankfully said I was not a candidate that it was time for surgery. Insurance did not agree. They wanted scans to show more damage. Try several cycles of injections, more physical therapy, then ablation. If - when that fails then surgery. All that to say it could be an insurance decision. Wishing you find relief the easier way.
K